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New Scientist Live

NHS game-changers: Rise of the data-empowered patient

By Jessica Griggs

How much do you know?

(Image: Samsung)

If handled well, the rise of the digitally empowered patient could fulfil the wildest dreams of NHS policy-makers&colon; a fitter, happier, more engaged public that sees the doctor less often. And when patients do make contact, they come armed with a diagnosis and data to back it up.

Apps and wearable technology already exist that can monitor sleep quality, calories, heart rate and physical activity. Soon we’ll be able to track blood pressure, glucose levels, blood oxygen content, respiration rate and temperature, not to mention emotional well-being. It won’t be long before smart devices will be detecting molecules in bodily fluids and diagnosing a complex array of conditions. “Within 10 years, I am quite sure that most smartphones or other gadgets will be able to do a serious amount of diagnosis,” says Charles Lowe, president of telemedicine and eHealth at the Royal Society of Medicine.

Within 10 years, phones and other gadgets will be able to do a serious amount of diagnosis

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That’s the dream, at least. But if what your watch or armband tells you causes anxiety, is hard to understand, or if there is a high rate of false positive results, the NHS could be overwhelmed. And if there is a high rate of false negatives, then people will be misleadingly reassured and so not see a doctor when they need to.

So what can be done to ensure the technology complements the NHS? The National Information Board was set up last year partly to investigate how digital services can “support prevention and self-care”. “We want to encourage people to be part of the social movement that is actively encouraging healthy behaviours,” says Tim Kelsey, NHS England director for patients and information. Bruce Keogh, the service’s national medical director is also a fan&colon; “These devices will put patients in the driving seat of their own care and allow us in the NHS to predict things, act early and keep people safe and healthy in their homes for as long as possible.”

A major goal is to provide people with a list of NHS-endorsed apps and eventually other self-care devices. The idea is that endorsement will allow doctors to trust and prescribe apps. To get to this point, independent trials will be needed to establish the efficiency of each one. “We need to know what the benefits are of the apps and devices,” says Lowe, who wants an app-testing equivalent to the randomised clinical trials used to assess drugs. “Once they’ve done it for apps, they can do it for wearables, and everything else.”

When there’s a set of high-quality apps and gadgets to choose from, the next task is to ensure the support systems are there to deal with the data these technologies create. These could include smart analytics that trawl through patient-generated data and alert the doctor to anything amiss. Or 24-hour support for products that send the data directly to the patient. This could be in the form of a website, a call centre staffed by medical professionals or even just an algorithm. “As long as you get good advice, after a while you probably wouldn’t care or notice whether it was a human doctor or a computerised doctor on the other end,” says Lowe.